本文關(guān)鍵詞：頸靜脈孔區(qū)不同手術(shù)入路顯露結(jié)構(gòu)的對比分析及顯微解剖研究　出處：《蘭州大學(xué)》2012年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 頸靜脈孔區(qū) 手術(shù)入路 顯微解剖 高頸位 顯露結(jié)構(gòu)

【摘要】：目的：研究枕下遠外側(cè)入路、耳后乙狀竇前經(jīng)顳入路、改良的耳后頭頸入路對頸靜脈孔區(qū)顯露范圍與結(jié)構(gòu)的區(qū)別；熟悉該區(qū)域的解剖結(jié)構(gòu),為臨床選擇個體化手術(shù)入路、盡可能的一期全切除腫瘤、保護重要結(jié)構(gòu)和功能提供可靠的依據(jù)。 方法：用10%的福爾馬林固定的成人頭頸濕標(biāo)本6具(12側(cè)),隨機分為A、B、C三組,每組2具標(biāo)本,在高倍顯微鏡下模擬頸靜脈孔區(qū)手術(shù)入路。其中A組模擬枕下遠外側(cè)入路、B組模擬耳后乙狀竇前經(jīng)顳入路、C組模擬改良的耳后頭頸入路進行顯微解剖研究,比較三種手術(shù)入路所顯露的結(jié)構(gòu)及范圍； 結(jié)果：枕下遠外側(cè)入路對頸靜脈孔區(qū)顱內(nèi)結(jié)構(gòu)顯露良好,特別是枕骨大孔區(qū)以及腦干下部的前方和側(cè)方；耳后乙狀竇前經(jīng)顳入路對頸靜脈孔孔內(nèi)結(jié)構(gòu)、鼓室、乳突氣房及頸動脈鞘周圍的結(jié)構(gòu)顯露良好,對顱內(nèi)部分顯露較差；改良的耳后頭頸入路則通過后、外、上、下等多個角度對顱內(nèi)外結(jié)構(gòu)均顯露良好。 結(jié)論：不同的手術(shù)入路對頸靜脈孔區(qū)的顯露范圍及結(jié)構(gòu)各不相同,改良的耳后頭頸入路能夠更好的從多角度對顱內(nèi)外結(jié)構(gòu)顯露,從而達到一期全切腫瘤。因此,根據(jù)頸靜脈孔區(qū)病變的范圍選擇不同的手術(shù)入路以及選擇磨出不同的骨性標(biāo)志對有效顯露和切除病變,減少結(jié)構(gòu)和功能破壞具有非常重要的意義。
[Abstract]:Objective: to study the difference of the exposure range and structure of the jugular foramen area between the far lateral suboccipital approach the posterior sigmoid sinus anterior and temporal approach and the modified retroauricular head and neck approach. Familiarity with the anatomical structure of the region provides a reliable basis for the clinical selection of individualized surgical approaches, as well as for the primary total removal of tumors and the protection of important structures and functions. Methods: six adult head and neck wet specimens with 10% formalin fixation were randomly divided into three groups: group A (n = 2) and group C (n = 2). The surgical approach of jugular foramen area was simulated under high power microscope. The microanatomical study was carried out in group A (simulated far lateral suboccipital approach) and group B (simulated retroauricular sigmoid sinus approach via temporal approach) and modified retroauricular head and neck approach (group C). The structure and scope of the three approaches were compared. Results: the cranial structure of the jugular foramen was well exposed by the far lateral approach of the occipital, especially the anterior and lateral areas of the foramen magnum and the lower part of the brain stem. The posterior sigmoid sinus was well exposed to the structures in the foramen of jugular vein, tympanic chamber, mastoid gas chamber and the sheath of carotid artery via temporal approach. The modified retroauricular head and neck approach was used to reveal the intracranial and external structures at different angles. Conclusion: the exposure range and structure of the jugular foramen area are different in different surgical approaches, and the improved retroauricular approach can better expose the intracranial and external structures from multiple angles. Therefore, according to the range of lesions in the jugular foramen, different surgical approaches and different bone markers can be used to effectively expose and remove the lesions. It is very important to reduce the damage of structure and function.
【學(xué)位授予單位】：蘭州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R322;R651.1

【參考文獻】

相關(guān)期刊論文 前7條

1 王洪正;戴黎萌;許燕球;沈偉鋒;劉窗溪;韓國強;陳建良;吳耀晨;徐如祥;;遠外側(cè)經(jīng)枕髁經(jīng)頸靜脈結(jié)節(jié)手術(shù)入路的量化分析[J];中華神經(jīng)醫(yī)學(xué)雜志;2006年05期

2 施輝;周輝;顏世為;李愛民;;枕下乙狀竇后鎖孔入路的臨床解剖學(xué)研究[J];臨床醫(yī)學(xué);2008年04期

3 潘亞文;袁賢瑞;劉慶;段磊;張建生;;經(jīng)乙狀竇后入路對橋小腦角區(qū)的顯露及損傷程度的評價[J];中華神經(jīng)外科疾病研究雜志;2008年02期

4 王勇利;蔣衛(wèi)紅;章華;柒琳;吳平;肖健云;司勇鋒;趙素萍;;不同手術(shù)入路對頸靜脈孔區(qū)顯露程度的比較研究及其臨床應(yīng)用價值探討[J];中國耳鼻咽喉顱底外科雜志;2010年01期

5 趙繼宗,王忠誠,何青;頸靜脈體化學(xué)感受器腫瘤——(附三例臨床報告)[J];中華神經(jīng)外科雜志;1993年06期

6 張明廣,徐啟武,鮑偉民,王克強;改良經(jīng)頸靜脈孔入路的顯微解剖研究[J];中華神經(jīng)外科雜志;2003年02期

7 劉慶;于春江;袁賢瑞;閆長祥;楊軍;岳穎;黃玉寶;;不同解剖入路顯露頸靜脈孔區(qū)的定量研究[J];中華外科雜志;2007年08期

，

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